P Moons

Is the severity of congenital heart disease associated with the quality of life and perceived health of adult patients

Objective: To explore whether the severity of congenital heart disease is associated with the quality of life and perceived health status of adult patients. Design: Descriptive, cross sectional study. Setting: Adult congenital heart disease programme in one tertiary care centre in Belgium. Patients: 629 patients (378 men, 251 women) with a median age of 24 years. Main outcome measures: Disease severity was operationalised in terms of initial diagnosis (classification of Task Force 1 of the 32nd Bethesda Conference), illness course (disease severity index), and current functional status (New York Heart Association (NYHA) class, ability index, congenital heart disease functional index, and left ventricular ejection fraction). Quality of life was measured by a linear analogue scale, the satisfaction with life scale, and the schedule for evaluation of individual quality of life. Perceived health status was also assessed with a linear analogue scale. Results: Scores derived from the disease severity classification systems were weakly negatively associated with quality of life and health status, ranging from −0.05 to −0.27. The NYHA functional class and ability index were consistently associated with quality of life and perceived health. Conclusions: This study showed that the severity of congenital heart disease is marginally associated with patients’ quality of life and perceived health. Functional status was more related to patients’ assessment of their quality of life than was the initial diagnosis or illness course.

Patients’ appraisal of side effects in quality of life assessments of immunosuppressive regimens

Quality of life has emerged as an important outcome measure in health care over the past two decades, and is increasingly used to evaluate treatment options. Indeed, understanding the quality of life implications of a new treatment modality in addition to studying its effects in terms of incidence of complications and mortality rate provides a more sophisticated and balanced view of treatment effects. Quality of life data offer a more complete understanding of the benefit/burden ratio associated with medical treatments in terms of patients’ physical, emotional/mental and social functioning.

European cardiovascular nurses attitudes and experiences of having family members present in the resuscitation room

the problem-solving process are central. An integration of different areas of knowledge, theoretical as well as clinical can be used. Motivation can be seen as an important factor for adherence. Drieschner et al (2004) have described 6 internal determinants for treatment motivation; problem recognition, level of suffering, external pressure, perceived cost of treatment, perceived suitability of treatment, and outcome expectancy. These determinants as well as Selfdetermination theory (Decci & Ryan 2000) have been used as the base to develop an educational program using PBL to create motivation to engage in CPAP treatment.

Symptom experience associated with immunosuppressive drugs after liver transplantation in adults

Abstract:  Symptom experience (occurrence and perceived distress) associated with side effects of immunosuppressive medications in organ transplant patients may well be associated with poorer quality of life and medication non‐compliance. The aims of this study were: first, to assess symptom experience in clinically stable adult patients during long‐term follow‐up after liver transplantation; and second, to study the relationship between symptom experience and medication non‐compliance. This cross‐sectional study included 123 liver transplant patients. Symptom experience was assessed using the “Modified Transplant Symptom Occurrence and Symptom Distress Scale” (29‐item version) at the annual evaluation. According to the duration of follow‐up, patients were divided into a short‐term (1–4 yr) and a long‐term (5–18 yr) cohort. Medication non‐compliance was measured using electronic monitoring. Results showed that increased hair growth was the most frequent symptom in both sexes. Symptom distress was more serious in women than in men. The most distressing symptom in women was excessive and/or painful periods, while in men this was impotence. Clear differences were revealed at item level between symptom occurrence and symptom distress in relationship with the two time cohorts and between sexes. No relationship was found between symptom experience and prednisolone non‐compliance.

Symptom experience associated with immunosuppressive drugs after liver transplantation in adults: possible relationship with medication non-compliance?: Symptom experience in liver transplantation

Abstract:  Symptom experience (occurrence and perceived distress) associated with side effects of immunosuppressive medications in organ transplant patients may well be associated with poorer quality of life and medication non‐compliance. The aims of this study were: first, to assess symptom experience in clinically stable adult patients during long‐term follow‐up after liver transplantation; and second, to study the relationship between symptom experience and medication non‐compliance. This cross‐sectional study included 123 liver transplant patients. Symptom experience was assessed using the “Modified Transplant Symptom Occurrence and Symptom Distress Scale” (29‐item version) at the annual evaluation. According to the duration of follow‐up, patients were divided into a short‐term (1–4 yr) and a long‐term (5–18 yr) cohort. Medication non‐compliance was measured using electronic monitoring. Results showed that increased hair growth was the most frequent symptom in both sexes. Symptom distress was more serious in women than in men. The most distressing symptom in women was excessive and/or painful periods, while in men this was impotence. Clear differences were revealed at item level between symptom occurrence and symptom distress in relationship with the two time cohorts and between sexes. No relationship was found between symptom experience and prednisolone non‐compliance.